Abstract
Objectives
Within health care, there are underserved groups. New Brunswick’s French-speaking minority, which also mostly lives in rural communities, is one such group. A physician shortage potentially prevents this population from accessing health promotion and clinical prevention services. This study analyzes whether New Brunswick Francophone doctors with rural backgrounds are more likely than doctors from urban regions to set up practice in rural communities of the province.
Methods
A questionnaire was sent to 390 New Brunswick Francophone physicians admitted in medicine between 1973 and 2000. It collected information on geographic origin and history of medical practice. Multivariate logistic regressions were used to identify whether a rural background is associated with the likelihood of ever and currently practicing in rural communities. We used the General Practice Rurality Index-simplified to quantify the rurality level of communities.
Results
In total, 264 (67%) physicians participated. A rural background was positively associated with the establishment of a first medical practice in a rural community. This relationship was only significant among family physicians. There was no statistically significant relationship between rurality of community of origin and rurality of current community of practice among either family or specialty physicians.
Conclusion
Although Francophone doctors with a rural background were more likely than their urban counterparts to set up their first practice in a rural community, this effect was not sustained. This raises questions as to why they leave rural communities and highlights the importance of measures to retain doctors as a way to promote public health for underserved rural groups.
Key Words: Medically underserved area, minority groups, rural health services, personnel recruitment, professional practice location
Résumé
Objectifs
Dans le domaine des soins de santé, il y a des groupes mal desservis. La minorité francophone au Nouveau-Brunswick, qui réside principalement dans des collectivités rurales, en est un exemple. Une pénurie de médecins pourrait empêcher cette population d’accéder à des services cliniques de prévention et de promotion de la santé. Dans cette étude, nous étudions s’il est plus probable que les médecins francophones néo-brunswickois d’origine rurale établissent leur pratique dans les régions rurales de la province que leurs homologues d’origine urbaine.
Méthodologie
Nous avons envoyé un questionnaire à 390 médecins francophones néo-brunswickois admis en médecine entre 1973 et 2000. Ce sondage a rassemblé des renseignements sur l’origine géographique et sur l’historique de la pratique médicale des participants. Nous avons effectué des analyses de régression logistique multivariée pour découvrir si l’origine rurale est liée à la probabilité qu’un médecin établisse sa pratique ou poursuive sa pratique dans une collectivité rurale. Pour quantifier le niveau de ruralité des collectivités, nous avons employé l’indice de ruralité en pratique générale (IRPG) (cote simplifiée).
Résultats
Au total, 264 (67 %) médecins ont participé à l’étude. Nous avons trouvé une corrélation positive entre l’origine rurale et l’établissement d’une première pratique médicale dans une collectivité rurale. Par contre, cette corrélation est seulement statistiquement significative chez les médecins de famille. Nous n’avons pu établir aucune corrélation significative entre la ruralité de la collectivité d’origine et la ruralité du lieu de pratique actuel pour les deux groupes de médecins.
Conclusion
Bien que les médecins francophones d’origine rurale soient plus susceptibles que leurs homologues urbains à s’établir dans une collectivité rurale comme premier lieu de pratique, cet effet n’a pas été soutenu. Cette étude suscite des questions relatives aux raisons qui poussent ces médecins à quitter les collectivités rurales et souligne l’importance de prendre des mesures visant à retenir les médecins afin de promouvoir la santé publique pour les groupes mal desservis.
Mots Clés: groupes mal desservis en matière de soins de santé, minorité, recrutement du personnel, lieu de pratique professionnelle, services de santé rurale
Footnotes
Acknowledgements: The authors thank the many participants, the evaluation committee and reviewers for editorial comments and suggestions, Rachelle Kerry and Rita Landry for their work during data collection, as well as Consortium national de formation en santé for partly funding this project.
Conflict of Interest: None to declare.
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